Deputy Minister Mensah said: “You can see that there have been improvements since the last time you were here. That means the people are taking up the challenge and improving some of the conditions. But we need to still do more. We have to sensitize the people, educate them on the rights of every individual. They cannot chain people in this way.”

In February 2019, the World Health Organization initiated, with the support of the UK’s development agency, its Quality Rights initiative in Ghana, an e-learning program aimed at training at least 5,000 people on ways to improve the quality of mental health services and ensure respect for human rights, including through obtaining informed consent from the person involved.

Based on interviews with seven mental health professionals and advocates in early November, most of whom had completed the training, Human Rights Watch believes that there has been a marked shift in the attitudes and practices of staff in Accra Psychiatric Hospital and among mental health professionals who administer medication to people in some prayer camps.

A nurse who works at Tetteh Quarshie Regional Hospital said, “Mental health is not just about taking medication. ‘Take your drug. Take your drug.’ Trying to force medication is not right. There is more to it.”

A nurse at Accra Psychiatric Hospital said: “Try to talk to the patient, to find out how you could help the patient – or what the patient thinks could be done to help them to get out of an aggressive mood. It’s possible to do without seclusion.”

A number of efforts led by local nongovernmental organizations, especially groups of people with psychosocial disabilities, are also underway. For example, MindFreedom Ghana has teamed up with the Human Rights Advocacy Center to conduct human rights training for psychiatric nurses and traditional healers. Another organization, Basic Needs Ghana, has been facilitating peer support groups. The Mental Health Society of Ghana is working with Time to Change in the UK to combat stigma and challenge stereotypes by highlighting the experiences of people with mental health conditions who have jobs, families, and are part of their communities, especially through social media.

Despite this progress, the government of Ghana should take further steps to end shackling by setting up the Visiting Committees outlined in the Mental Health Act to monitor prayer camps and traditional healing centers to enforce the ban, and by investing in community mental health services that respect human rights. The government should also ensure that people with psychosocial disabilities get adequate support for housing, independent living, and job training.

The government should follow through on commitments to sensitize the public and to combat the stigma associated with mental health conditions, Human Rights Watch said. Finally, the government needs to set up the levy envisaged under the 2012 Mental Health Act to fund mental health services as a matter of priority.

“It was promising to see that the ban is having its intended effect in some camps,” Barriga said. “But many people with real or perceived mental health conditions are still chained or locked up. Just as the minister said, ‘This needs to stop.’ The government needs to move from rhetoric to reality.”